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Methylergonovine (Oral route)

Pronunciation:

meth-il-er-goe-NOE-veen

Brand Names:

  • Methergine

Dosage Forms:

  • Tablet

Classifications:

Therapeutic—

Uterine Stimulant

Chemical—

Ergot Alkaloid

Uses of This Medicine:

Methylergonovine is used to prevent and control bleeding from the uterus that can happen after childbirth. It belongs to the class of medicines called ergot alkaloids. This medicine works by acting directly on the smooth muscles of the uterus and prevents bleeding after giving birth.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of methylergonovine in the pediatric population. Safety and efficacy have not been established.

Older adults—

Although appropriate studies on the relationship of age to the effects of methylergonovine have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving methylergonovine.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Almotriptan
  • Amprenavir
  • Atazanavir
  • Azithromycin
  • Boceprevir
  • Clarithromycin
  • Cobicistat
  • Darunavir
  • Delavirdine
  • Dirithromycin
  • Efavirenz
  • Eletriptan
  • Erythromycin
  • Fosamprenavir
  • Frovatriptan
  • Indinavir
  • Itraconazole
  • Josamycin
  • Ketoconazole
  • Lopinavir
  • Mepartricin
  • Miokamycin
  • Naratriptan
  • Nefazodone
  • Nelfinavir
  • Posaconazole
  • Ritonavir
  • Rizatriptan
  • Rokitamycin
  • Roxithromycin
  • Saquinavir
  • Spiramycin
  • Sumatriptan
  • Telaprevir
  • Tipranavir
  • Troleandomycin
  • Voriconazole
  • Zolmitriptan

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Fluconazole
  • Fluvoxamine
  • Telithromycin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Coronary artery disease or
  • Diabetes or
  • Hypercholesterolemia (high cholesterol in the blood)—May increase risk for more serious side effects.
  • Hypertension (high blood pressure) or
  • Toxemia (high blood pressure during pregnancy)—Should not be used in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Obliterative vascular disease (blood vessel disease) or
  • Sepsis (severe infection in the blood)—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice may change the amount of this medicine that is absorbed in the body.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prevention of bleeding after childbirth:
      • Adults—0.2 milligram (mg) three or four times a day, for up to 1 week.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits while you are taking this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Using this medicine while you are pregnant can harm your unborn baby. This medicine may cause contraction of the uterus and cause you to give birth early.

This medicine may increase your chance of having a heart attack. This is more likely to occur if you have diabetes, high cholesterol, or if you smoke or are overweight. Call your doctor right away if you have chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, trouble breathing, or sweating while using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Abdominal pain
headache
increased blood pressure
Rare
Blood in the urine
change in skin color
chest pain or discomfort
difficult or labored breathing
difficulty with swallowing
dizziness
fast, pounding, or irregular heartbeat or pulse
hives
lightheadedness, dizziness, or fainting
pain or discomfort in the arms, jaw, back, or neck
pain, tenderness, or swelling of the foot or leg
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
slow or fast heartbeat
skin rash
sweating
vomiting
Incidence not known
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
inability to speak
seizures
severe or sudden headache
slurred speech
temporary blindness
weakness in the arm or leg on one side of the body, sudden and severe

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare
Continuous ringing or buzzing or other unexplained noise in the ears
cramps in the legs
diarrhea
foul taste
increased sweating
nausea
stuffy nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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